Pf-did - Blog Posts

Citing outdated research is something I've started seeing a lot of lately. This time I will focus on people utilizing Kluft's 1988 Complex MPD paper to state that polyfragmentation can be as low as part counts in the 20s, that polyfragmentation is "poorly defined and debated," and that severe abuse does not need to occur for polyfragmentation to develop. So let's break this down.

Research is considered outdated if it is 10+ years old (and in some fields, anything 5+ years old). This paper was published 34 years ago.

Kluft's sample was 26 people with 26+ parts, 24 of which are AFAB and 2 are AMAB, 94% white. This is extremely small for a research study and not At All representative of any population.

In the abstract of the paper it states this: "48 of the 76 cases reviewed [...] had dual (2) personalities. Another 12 had 3 personalities. Only 1 individual, a patient with 12 personalities, had more than 8." Emergent research at the time was beginning to show higher parts counts--it cites several authors that put the average as 2-10, 6.3, 13.3, 13.9, 15.4, and 15.8. All of these studies had sample sizes less than 100 (mostly sub-50) except for the 15.8 number which had a sample size of 355. Kluft outright states that alter count is being investigated at that point. Note the vast majority of these studies, including the emergent research, output a lower alter count than is considered average today.

Kluft states that "Somewhat arbitrarily, [he] defined extreme complexity as the presence of at least twice as many alters as the upper limit of the modal range of 8-13, ie 26 or more." Key note here is that this Kluft's personal definition of complexity (not a widespread consensus) at a time when alter count was being openly investigated as essentially an unknown (he is using the upper limit as in the extreme end of averages per the previous emergent research indications, not that this was now widely considered the average alter count). Kluft was one of the very few people who even dealt with complex cases, with most of his colleagues opting to pass them onto him (as is noted in the paper), so essentially there was very little besides his own personal opinion to go off of.

Kluft notes that his observed rate of seeing complex MPD cases "constitute approximately 15-20%" of his patients, and that his "experience with very complex cases began in 1975." This means that of the cases he was seeing over the past decade, only 15-20% of his DID cases had 26+ parts. Or, 80-85% of his clients had fewer than 26 parts.

Kluft's phrasing in this paper that "chaotic and unsafe" home environments are a pathway to complex MPD has been used lately as "proof" that polyfragmentation does not need to occur from RAMCOA or severe abuse settings and can come from simply having an unstable home environment. This is a cherry-picked phrase and should not be used as evidence, because of the next point:

His findings for people with 26+ parts: 100% experienced "long-standing severe abuse." 46% had abuse histories that were documented legally in the 70s or corroborated by witnesses. It is nearly impossible to win a court case NOW against your abuser, much less in the 70s, and having witnesses to abuse is also a marker that the abuse was severe as abusers tend to abuse when others aren't around--for them to escalate is heavy. Not to mention the 70s were much stricter about what was considered abuse. 92% were incest survivors. 58% experienced "vicious torment." 35% were RA survivors. The exact percentage isn't listed but Kluft states that in addition to the 35% RA survivors in his sample, another 1/3rd (~33%) stated that others "manipulated their condition"--due to his grouping the two together I am inclined to think that there were likely overlaps in experience with RA and this, though we can't be sure. It's important to keep in mind here that the alter count is 26+.

What this study states is not that polyfragmentation is ill-defined in 2022. What it states is that in the 1980s, researchers were still trying to figure out what the average alter count even was. Much less polyfragmentation.

This study states that among a small group of people with 26+ parts, all of them had severe abuse histories and the overwhelming majority were incest survivors. This is evidence AGAINST the claim that polyfragmentation can occur in merely unstable households, not for it. Its evidence is that severe abuse is needed to develop above average alter counts, quoting Kluft with the phrase "the more traumata, the more alters." The fact that in a study for 26+ parts, over 1/3rd were RA survivors is a significant marker of this.

Not only this, but it is evidence AGAINST the idea that high alter counts in DID are common at all. If 80-85% of Kluft's patients had under 26 parts, it would indicate that above average alter counts in the 26+ count are a minority and that would indicate that having 100+ parts would be even more so.

Now, current evidence does not support the idea of a tit-for-tat "every trauma = another alter" idea that Kluft put forth. Current evidence shows that 50% of people with DID have 10 or fewer parts, which doesn't discount Kluft's experience of 80-85% of cases having fewer than 26, but does make it more unlikely given our higher average alter count now (as in, it is likely a higher number of people have 26+ parts than Kluft thought). Currently there is a stable definition of polyfragmentation as 100+ parts (with implied complexities), for the past ~15+ years, through the training provided by OEA SIG of the ISSTD and various texts including Christiane Sanderson's Counseling Adult Survivors of CSA. But this is why we should not use decades old research as if it wholly relevant--we can use it as a reference point but it is not accurate or up to date. It's also why cherry-picking phrases in research can lead one to wildly different conclusions than what it actually stated.